This invention relates to a method for forming a surgical closure. This invention also relates to a device for use in the method. More specifically, this invention relates to a surgical instrument and an associated method for forming a closure in organic tissues of a patient in a minimally invasive endoscopic operation. The invention is useful in laparoscopic, arthroscopic, thoracoscopic, etc., procedures.
Minimally invasive surgical procedures such as laparoscopy, arthroscopy, thoracoscopy, etc., use endoscopes (laparoscopes, arthroscopes . . .) for enabling visual observation of a surgical site below the patient's skin surface. These minimally invasive operations generally entail the placement of one or more cannulas in the patient's skin. The cannulas penetrate to the surgical site and various instruments are inserted through the cannulas to perform an operation on organic tissues which remain mostly covered by the skin surfaces of the patient.
A continuing problem in such minimally invasive operations is the formation of surgical closures inside the body. The suturing of an incision, the closure of a wound or the ligating of a tube inside the body through endoscopic cannulas is a difficult and tedious task. Various methods have been proposed for simplifying and facilitating the formation of sutures. U.S. Pat. No. 5,037,433, for example, discloses a method for performing a surgical operation on internal body tissues of a patient which comprises the steps of inserting a tubular endoscope member through an aperture in the patient's body, using the endoscope to visually locate the internal body tissues inside the patient's body, and upon locating the surgical site, pushing an elongate flexible rod member in a distal direction through a biopsy channel in the tubular endoscope member to eject a needle disposed in a straightened configuration inside the channel at a distal end of the tubular endoscope member. In this method, the needle has a spring bias construction tending to automatically bend the needle into an arcuate configuration, and the needle further has a proximal end attached to a suture. Upon ejection of the needle from the endoscope biopsy channel, the needle is passed in the arcuate configuration through the internal body tissues. After passing of the needle through the internal body tissues, the suture is closed, whereupon the tubular endoscope member is withdrawn or removed from the patient's body though the introduction aperture.
Other recently proposed methods entail the tying of sutures outside the body and sliding the suture ties down through a cannula to the surgical site inside the patient.
Nevertheless, despite these recent proposals, no method has been generally adopted by surgeons who regularly perform minimally invasive surgical operations.